Stretching

Regardless of which physiotherapist you see or which sport you have played in your lifetime, you are bound to have heard or been told that stretching is good for you.

The truth? It is, BUT… there are different types of stretching and it is important you use the right type of stretching at the right time!

Being aware of the possible risks of each type of stretching could make a difference to your likelihood of injury or even your performance!

The main types of stretching are; Static, Dynamic, Proprioceptive Neuromuscular Facilitation and Ballistic.

Static Stretching is the type of stretching that we all know well. You tension a muscle until you feel a stretch, then hold for a period of time (usually 20-30 seconds).

Pros:

Increases the extensibility of the muscle(s) stretched

With prolonged repetition can increase muscle length

Cons:

It can increase the risk of injury if done before exercise because of an increased risk of instability.

Has been shown to reduce muscle power by 7-8% and muscular endurance by up to 30% for up to 24 hours.

When is it appropriate? After exercise to release tightened muscles and if you are looking to increase overall flexibility and muscle length.

Dynamic stretching is a stretching technique that we may not all be familiar with. It uses momentum to stretch a muscle for a short period within its range of motion. Below is a video that runs through an example of a dynamic stretch.

Pros:

Has shown to improve muscular strength, power, endurance and agility

Appropriate during a pre-exercise warm up without compromising stability

Cons:

Does not provide an overall lengthening of muscles

Can be hard to perform without demonstration or clear instruction

When is it appropriate? Before exercise and daily during rehabilitation programs if appropriate.

Proprioceptive Neuromuscular Facilitation is simply shortened to PNF. It is a form of stretching with the aim of providing large increases in range of motion in a short time by contracting opposing muscles against a passive stretch, or in other words, pushing against a static stretch.

Pros:

Can produce large increases in range of motion and muscle extensibility in a short time

Has the same effects on muscle power and endurance as static stretching

Can lead to injury if not performed correctly and safely

When is it appropriate? After exercise to release tightened muscles, to release muscle spasm and as part of exercise programs to increase flexibility and performance. It is, however, not always necessary and you should consult your physiotherapist on how to do these stretches correctly and to determine which stretches are most appropriate for you.

Ballistic Stretching is similar to static stretching, but involves a bouncing at end of range. It is not recommended as it is not shown to have any lasting benefits and there is an increased risk of injury when performing the stretches.

For more examples of stretches, feel free to view some of our other posts by clicking the links below.

Whether you are a professional marathon runner or simply enjoy a recreational jog it is likely that you have experienced pain in the Achilles tendon at some point. The pain will generally be most prominent during warm-up, settle down significantly as you run only to return with a vengeance after you have cooled down after running! If it continues to worsen, it can become very debilitating and prevent from running altogether!

This article will help to arm you with the anatomical information and practical knowledge necessary to help recognise Achilles tendon pain and how to manage it!

Firstly, it is important that you know the anatomy of your Achilles!

The Achilles tendon joins the calf muscle to the heel bone. Tendons are a soft tissue structure made up of the elastic material called collagen and always attach muscles to bone. The role of the Achilles tendon is to transfer the power produced by your calf muscles through to the heel bone to move the ankle joint and provide you with forwards thrust as you run.

Pain in this area can be as a result of tendonitis (inflammation of the tendon) or tearing. It can sometimes start very suddenly after a big load through the tendon, such as falling into a pothole as you run. More commonly, pain in the Achilles develops a gradually over time as a result of overuse and worsens unless managed appropriately.

Things that can predispose you to Achilles tendon pain are:

Poor foot mechanics (corrective orthotics or well prescribed sports shoes can help enormously)

Stiffness of the ankle joints (this can occur after an acute ankle injury such as a rolled ankle)

A significant and sudden increase in training load (such as further distance, increased regularity, or extra hills etc.)

Weakness of the hip or core muscles

To remedy the situation there are 5 simple things that you can do:

Stretching may aggravate the tendon! Avoid dropping your heel off a step or doing strong calf stretching as this is too aggressive for a sore or damaged tendon

Mobilising the sciatic nerve system before rising from bed can help with morning stiffness

If you spend a lot of time at a desk or do a lot of physical activity such as running and cycling then it is likely that you will have tightness in your hamstrings. Tightness in the hamstring muscle group can lead to knee pain, back pain and can increase the risk of tearing the hamstrings during activity.

To effectively isolate and stretch the hamstring muscle group it is crucial that your technique is right. There are a number of different “hamstring stretches” out there but the following video outlines the best way to get a strong isolated stretch into the hamstrings!

Do you spend hours bent over a workstation? Does your job involve repetitive bending and heavy lifting? Do you, like so many of us in recent years, use a tablet, smart phone or laptop computer for hours every day?

If you answered yes to any of the above then it is very likely that you will have developed stiffness in your upper back. This ‘thoracic region’ is the largest part of our spine. It starts at the base of your neck and ends just above the lower back.

As a result of daily habits, like those described above, and poor posture, the thoracic spine is more likely to become stiff. This may not present as a major problem initially but it can have flow-on effects to the lower back, neck and shoulders.

The most immediate obvious effect of thoracic stiffness is in an increase in the natural curvature of your upper back and causes you to stand with “rounded shoulders”. This poor posture that we so often adopt as a result of laziness of our muscles eventually becomes permanent as the joints lose their ability to move back into a more upright position!

There are two wonderfully effective stretches that can help to increase thoracic spine mobility:

1) The open book stretch: Lay on your side as shown. Breathe in as you move your top arm across your body and turn your head and shoulders with it, keeping your knee firmly placed on the floor. Breathe out as you hold the stretch for around ten to fifteen seconds, then return to the start and repeat 10 times.

2) Extension over ball: Place a small inflatable ball on the floor – an exercise ball is best as it is quite squishy but a soft soccer ball will also do. Lay over the ball positioned between your shoulder blades. Make sure your head is supported on a pillow or a rolled up towel and your legs are bent. Stretch for 2 minutes with your arms overhead, breathing fully and relaxing into the stretch.

Gardening can be the most restorative of activities – unless we overdo it, and most people will be guilty of that at some time or other.

The key is to not go at it like a bull at a gate, but to pace yourself (regardless of your age) and pause during repetitive tasks to let joints and muscles rest. Every fifteen minutes is a good target but don’t leave it more than half an hour before RESTING and performing the OPPOSITE movement for a short while.

Hands & Wrists:

Extended pruning with secateurs is a classic cause of RSI (repetitive strain injury).

Just pause now and then to stretch your fingers, hands and wrists in the opposite direction to the pruning action. Joints will recover, muscles will shed their fatigue and you’ll be more efficient.

Shoulders:

While pruning or clipping overhead your shoulders will take most of the strain. Just pause for a few moments and roll your shoulders down and back in a circular motion for one minute. Apart from providing rest for the muscles, you’ll also relieve those joints and tendons temporarily. Remain standing tall during the exercise and keep your chin in.

Back:

While digging, raking or bending to weed, stop and arch your spine and shoulders backwards with hands pushing your pelvis forwards. It’s a classic for very good reason as it allows the gelatinous content of squashed discs to revert to balance again.

I see so many patients suffering from lower back pain from gardening, yet this small exercise can prevent so much discomfort.

Knees:
Many gardening tasks involve kneeling and even if you’re wearing kneepads to protect the front of your knees, the knee joint and surrounding tendons needs rest and opposite action too. So stand up and give them a rub and a wiggle (that’s a technical term for repetitive re-traction by the way).

Painful Joints:

Many mature gardeners will suffer some occasional joint pain, whether it be arthritic or rheumatic and many will avoid outdoor activities at these times. But all joints benefit from movement as it stimulates joint lubrication which in turn provides the nutrition for the joint linings and cuffs.

People who immobilise tetchy joints do themselves no favours as the joint will become stiff and produce even more pain. If you have painful joints and decide to do some gardening then warming up first is all the more important as this will minimise the initial discomfort.

But, as with all things to do with health, all movements should be performed in moderation. Stop if sharp pain persists and consult a doctor.